Existential Psychotherapy for Beginners: An Essential Guide

All right, in today's, uh, lesson, we're going to learn all about existential theory and its application to psychotherapy. So, um, we'll be talking about the roots of existential therapy and how it, uh, emerged from existential philosophy. Now, if we were to think of the word "existential" and look for its root, uh, the root of the word is "exists" or "existence," right? So, one of the foundational questions around existential therapy is trying to figure out, well, what is one’s purpose in life and how to make meaning of the world that they’re in? So, obviously, from

an existential philosophy, um, the focus is on things like death, right, which is a bookend of life, uh, responsibility [Music], uh, free will or freedom, and the pursuit of, uh, meaning and meaning-making, right? So, Viktor Frankl is one of the leading figures in this field, and one of his relatively famous quotes is, "Man also only returns to himself to be concerned with his self after he has missed his mission, has failed to find meaning in life." Right? So, um, the emphasis of this quote is that with hardship and with failure, it's an opportunity to reassess.

So, uh, existential psychotherapy focuses on self-awareness, uh, facing the challenges of life and human existence, and encourages us to become a more authentic being. So, as a whole, um, this approach, existential psychotherapy, focuses on a composite individual, and it goes away from a reductionist model of trying to break people down to, uh, their biochemistry, their DNA, or their childhood or social or educational experiences. Uh, the composite individual—the whole person—uh, is far greater than all of its elements, and we're going to hear that stated very nicely when we talk about gestalt, right? So we are meaning-makers

as individuals; we're always trying to understand, well, why did this happen? Um, what can I learn from it? How do I grow from it? Trying to seek meaning out of, uh, the experiences we have. Uh, so this particular model of therapy puts a strong emphasis on getting that deep understanding of what we're living for and why we're here. So, if we were to do a brief history, there are some philosophers that are important to understanding existential philosophy. So, Kierkegaard, uh, he was a pretty re—uh—related religious individual. He was, um, a famous philosopher living in Copenhagen,

and, uh, he, as I said, grew up pretty religious, but he had a crisis of faith. Through his crisis of faith, he determined that religious faith was irrational, right? Um, and that might come as a threat to some, uh, but he wasn't meant to, um, attack any individual personally, but he felt that, um, more important than religion are our choices. Our subjective choices, uh, values like responsibility and honesty and commitment were more important than, you know, worrying about a God figure hovering over you, trying to, uh, figure out why you did what you did. And

then we have Nietzsche, um, who, uh, also viewed religion, particularly Christianity, pretty negatively. In one of his, uh, books he says, "God is dead." So, he felt that religion was used as a tool, uh, to put pressure on people to behave morally when, in reality, um, we don't believe that people who are religious are more moral than people who are irreligious or non-religious, right? So that's what we—that's where we're at today. Uh, so instead of focusing on, um, reward and punishment and [Music], you know, if you don't do this, God’s gonna be upset with you,

he put emphasis on positive activities such as creativity, uh, things that make you happy—joyful activities. And obviously, um, what provides me happiness isn't necessarily what provides another person happiness, but the focus should be on living a high-quality life and doing the things that make you happy. You know, [Music] Steve Jobs is a good example of someone who was a master at this, and he once gave a commencement address, um, at Stanford University, I believe it was, and he talked about his philosophy of life, which is that if he does something and he doesn't like it,

um, and then another day goes by and he doesn't like it, a third day goes by and he doesn't like it, eventually he says, you know what? This isn't for me. And he moves on. So, uh, he also, in that graduation address, was talking about doing the things that make you happy and provide meaning in life for you. Um, and if it didn't, you know, provide him any happiness or satisfaction, he stepped away from many different things. Jean-Paul Sartre was another, uh, philosopher, a French philosopher, who talked about existentialism, and, uh, this is, uh, one

of the more powerful quotes from his work: "Man's essence is his existence." Right? So, finding your essence or your purpose in life is going to be important. And another quote is, "Freedom is existence, and existence precedes essence." Right? So, um, finding one's purpose in life, finding meaning, and living in accordance with one's essence is going to make our existence, uh, all that much more joyful in this world. Then we get to some of our psychology figures, people like Rollo May. Rollo May tried to explain Sartre's point of view, and he says, "That is to say,

there would be no essences, no truth, no structure in reality, no logical forms, no logos, no God, nor any morality, except as man, affirming his freedom, makes these truths." So, our mindset and our choice to believe in a higher power creates that higher power to some degree. Um, our, um, belief in what our purpose is makes that a defining force in who we are, and so forth. Viktor Frankl now, Victor… Frankl is an interesting figure as well. Um, you know he survived the Holocaust, right? He lost, uh, his entire family in the concentration camps, and

then he became a psychiatrist and came up with this logo therapy, uh, in his book *Man's Search for Meaning*. Now, if there is anyone that you could think of who might have a pessimistic worldview or a cynical worldview, it could be Viktor Frankl, right? Because he saw so many atrocities, right? But he took those experiences in life and he, uh, tried to understand—like, well, you know, I survived; what’s the purpose of that? What’s my role in life? So, um, he has a famous quote, um, or I should say he defines the famous quote of Nietzsche,

which is, “He who has a why to live can bear almost anyhow.” And one of the things I heard Viktor Frankl say was that, um, you are stripped of all your freedoms in the concentration camp. Uh, they tell you what to wear, where to go, when to get up, when to go to bed, uh, whether you're gonna live or die. Uh, but he said one of the things that kept him alive was finding small things that he could exert, uh, free will over and make choices. So, he—you know, he reframed a lot of the negative

experiences in the Holocaust, and he said, "Well, it’s true that they could tell me, um, when to get up, right? But I have a choice, whether when they tell me that, um, I get out of, uh, my bed and stand up in the barracks or I stay in bed." Now, obviously, the consequence of staying in bed would be fatal, but nevertheless, it’s still a choice. When they fed, uh, moldy bread and slop, he had a choice whether to eat it, not eat it, share it with other individuals who were weaker, and so forth. So, there

are all these little choices that he said they can’t take away from me, and that’s how he survived, right? So, uh, he tried to, um, exert free will as much as possible. All right, so he does come up with, uh, logotherapy, which is purely focused on meaning-making from a therapeutic model. And he talks about the Statue of Responsibility. Um, he wanted to build a statue on the West Coast, similar to the Statue of Liberty, which is in on the East Coast in New York, right? So, he felt that if the Statue of Liberty was symbolic

of freedom, then there should be another statue on the West Coast, symbolic of responsibility. Now, Rollo May—Rollo May, again, he brought existential psychology or existential thought into American psychotherapy. Interesting to note, Rollo May was a fairly influential figure, uh, not just in the American Psychological Association but in the New York State Psychological Association. Um, so he brings a lot of these existential therapies and thoughts, um, to the United States and New York psychology. So, in terms of, um, his life history as he moves, uh, forward, he starts as a missionary and eventually studies under Alfred

Adler. And we talked about Adler in the previous, uh, discussion about, you know, trying to, um, have that masculine protest and striving for superiority and reaching one’s potential. It should not shock you that he was influenced by this, and many of the existential ideas share some overlap with Alfred Adler. But studying with Adler in Vienna really, really impacted him in a way that he, uh, yeah, he got his divinity degree, but then he shifted gears, uh, towards, uh, clinical psychology. Now, uh, Rollo May—as I said, you know, he is pretty influential, but he wrote all

the way up into the 1980s. So, one of his quotes about, uh, existence is, “I happen to exist at this given moment in time and space, and my problem is how am I going to be aware of that fact and what am I going to do about it?” So, um, that was sort of a clarion call or a charge towards action to recognize that we are a product of our zeitgeist and our Geist—we're a product of our time, uh, and space, and, uh, our views and values are going to be influenced by that. Uh, you

know, in 2020, um, I happened to be the president of the New York State Psychological Association and, uh, before, you know, being elected I had so many lofty goals and things that I wanted to accomplish. Um, and then in 2020, COVID happened, and my priorities had to shift toward, uh, the needs of that time and the needs of, uh, being a New Yorker, right? In the early aspects of—in 1919, New York was one of the earliest hit and the heaviest hit. So, advocating for alternative ways to accumulate hours to get licensed and helping graduate students

graduate and helping practitioners be able to do remote therapy for telephone-only services—these became a top priority. And how to work with insurance companies, uh, that, you know, you would get appropriate reimbursement—um, these became top priorities. And while, uh, I did say that I wanted to protect practice and work towards that, you know, I could not have envisioned that, but I was given that responsibility, um, based on the time and place. And so, I was in that moment—I had to react to what the needs of the community were. And then you fast forward, uh, to, uh,

June, and you have the June 2020— you have the George Floyd incident. Um, and then there’s more of a, you know, belated awakening of, uh, racial inequities and trying to increase dialogue within and outside of the association around trying to become a more equitable society. That became a priority, and it's... True again! You know, when I think of what my mission statement was when I was running and elected, you know, one of my pillars is diversity. Diversity, equity, and inclusion were important to me before it became popular, but I was able to harness the experiences

of the time and actually move that agenda along. So when Rollo May says, "Okay, I'm existing at this moment in this time in this place; what am I going to do about it?" that means I have a responsibility to whoever is around me at that time and place. So, I give that example, and I'm not patting myself on the back, but it kind of highlights the point that we are born into a time period, we are born into a geographic area, and we have a responsibility to step up to the plate and address the needs

of that time and place. All right, so we also talk about dialectics, which are polarized positions or contrasting positions. Dialectic positions or contrasting positions are perfectly normal, and they are accepted. So people like Fritz Perls say, "Every psychological phenomenon is experienced as a polarity." Right? So it's perfectly fine to see things in poles and then to develop a synthesis around that. Right? So, it’s okay to see things at the poles, but to blend them and understand them, that’s going to be more important, and that's what Hegel talked about. Right? So he talks about dialectical processes,

and there are four steps of the process. First, you develop an idea, which automatically creates a polar opposite thought. Now, once you have these polar opposite thoughts, there's going to be conflict. Right? Our job is to reconcile this conflict, synthesize the opposing points of view, and create a higher truth. So that’s Hegel’s four-step process of dialectics. Now, existential philosophy—it's important to understand that I gave you a crash course. I didn’t cover everyone, so obviously, it didn’t start with Kierkegaard, Nietzsche, Sartre, and Hegel. Right? So, there were philosophers even before them. People like Socrates and Plato

had really incredible ideas that are thousands of years prior. And then, obviously, it doesn’t stop with these individuals. The same thing can be said about psychotherapy, right? So existential therapy doesn’t end with Alfred Adler, Viktor Frankl, and Rollo May. Right? It continues today. So, there are people like Irvin Yalom, and I'm not going to go through all of these individuals, but Irvin Yalom took existential theory and applied it to group counseling, and Kurt Schneider is one of the leaders in humanistic psychology. There are a lot of individuals who continue to develop these existential perspectives. Now,

let's go through some of the belief sets. Right? So Rollo May talks about "I am experienced," right? So that is an experience of being or of existing. Right? So you might hear this referred to as an ontological experience, which is, you know, trying to understand what it is like to exist in the here and now. Now, one of the cool things about existentialism is that it’s very present-to-future-oriented, whereas Freud was looking into your past more and how that shaped you until now. So, there’s always, you know, it’s an exploration. So, psychotherapy focuses on self-awareness and

self-discovery, and that’s where growth comes from. You know, I had a mentor, Dr. Stanley Graham, who, when I was doing my pre-doctoral internship, helped guide me in practice because sometimes we don’t want to touch on difficult topics or painful experiences too deeply, and he reminded me that growth comes from uncomfortable places. So, it’s perfectly fine to go there because that’s where the self-awareness and self-discovery are going to come from. Now, being in the world has four existential components or ways. So you have Umvelt, which is being with nature or the physical world; Mitwelt, which is

being with the social world; Eigenwelt, which is being with the world of the self; and then Überwelt, or the spiritual world. Now, all four of these planes of existence occur simultaneously and throughout everything in life. Right? So you cannot separate the physical world, social world, your view of the self, and spiritual world from who you are. They all happen at the same time, and they happen in every aspect of our life. Now, we also talk about the demonic, and demonic is not the same as demonic. Right? We’re not talking about demons, but a demonic is

an elemental force or energy that could be constructive or destructive in terms of impulses. And the demonic, this elemental force, can actually take over the whole person. Right? At least, according to Rollo May. Right? So Rollo May says, "The demonic is the urge in every being to affirm itself, assert itself, perpetuate, and increase itself." Right? So the goal is, if we are going to recognize that it could be destructive or constructive, the goal would be to take the energy force that resides inside of us and harness it into more constructive or creative behavior. So, anxiety.

Anxiety is normal. Right? Whenever you think about your purpose in life or existence, meaning, and things like that, that should create some level of anxiety. Now, there’s normal anxiety—and I put "normal" in quotes—and then there’s neurotic anxiety, also in quotes. Right? So normal anxiety is appropriate anxiety. It’s relatively proportional to the situation, so it’s not exaggerated or highly over-represented anxiety. The anxiety is relative to the situation. Anxiety is meaningful, and then it promotes some kind of solution or constructive action, whereas neurotic... Anxiety, as I said, is an overwhelming experience. It is disproportionate to the situation.

Uh, and because of that, we wind up avoiding, denying, or repressing our experience, and that results in us not, um, solving whatever problem we have. It's usually destructive in many ways. Now, guilt is another, uh, experience. Guilt does not necessarily have to be a bad thing, so normal guilt is considered functional. Um, it encourages us to become more conscientious in our actions and thoughts. It allows us to reflect on that which is appropriate, ethical, or moral, whereas neurotic guilt is a source of psychological illness or pathology, and it's exaggerated. Ultimately, um, this results in self-critical,

self-punitive ways. So, going to Irving D. Yalom, who talks about existential psychodynamics, he said there are four ultimate concerns that we all face: death, freedom, isolation, and meaninglessness. The concept of death—well, death and life exist simultaneously, right? We don't like to think about death. In fact, um, Ernest Becker wrote a book called "The Denial of Death," and he talks about how we go to great lengths not to face death. In fact, we don't even like to use the word "death." So if we have death surrounding us, we say, "Oh, they passed away," or "They went

to a better place." We use euphemisms not to have to deal with the feelings of death. But according to Yalom, death wears continuously beneath the membrane of life, and it exerts a vast influence upon our experiencing conduct. So we know it's there; we don't like to think about it, but it lurks beneath the surface at all times. Another thing we talk about is that death is a primordial source of anxiety or pathology, right? But to face death is to motivate oneself to drink with greater enthusiasm from the cup of life—a call to live in the

now as an individual self with freedom of choice. It's poetic, isn't it, what Yalom says? But ultimately, um, recognizing our mortality could inspire us to live life more fully. I'm sure you've heard the term "bucket list." Usually, um, most people don't write bucket lists early in their life, but as we get older, we're like, "Okay, well, what do we want to do before we die?" That's called a bucket list—before we kick the bucket, right? We don't want to say "die"; we say "kick the bucket." So that bucket list is our one attempt to live life

to the fullest. There's actually a great movie with Morgan Freeman and Jack Nicholson about the bucket list, right? You should watch it. It really shows you how people cope with the potential inevitability of death, I should say. Morgan Freeman takes a more constructive and positive approach toward making meaning and living life to the fullest, whereas in the beginning, uh, Jack Nicholson is all about basic pleasure and, uh, you know, trying to have one last hurrah. So it really talks about how people cope with death. It's pretty fascinating. Now, we also have freedom, right? Freedom is

another aspect of who we are. And so R.T.A., remember the philosopher, says we're condemned to freedom. Now, why is freedom a condemnation? Well, the truth is that if we have freedom, then our choices matter. And if our choices matter, then we have to be responsible for the choices we make. So, um, that's the burden of freedom: if you're free, then you have personal responsibility for the choices you make, and, um, you cannot blame others for your choices or non-choices. I see this a lot in couples therapy, where a person will, you know, talk about their

partner and how they're not doing this or they're not doing that, as if to say their partner is 100% to blame for all the problems. And that's not true. All relationships are shared responsibilities, shared choices. I oftentimes will say, you know, it sounds like you're just a fly on the wall observing this relationship. Uh, and then I'll follow it up with, "Well, what might you do that contributes to the problems you're facing in your relationship?" And notice the focus is shifted to that individual, challenging them to face, you know, their personal choices and their responsibilities.

So, existential isolation—nobody wants to be alone—but the reality is that we do enter the world alone, and we leave the world alone. Um, so when you're born and you die, there are very few people in your circle, very few people around you. But by nature, in that middle part between the bookends of life and death, we want to find connection. We are social animals. Uh, we desire and create connectivity, right? So, um, in general, as therapists, if we feel someone is socially isolated or existentially isolated, we will try and help them find more connection with

others, whether it be their friends, whether it be family members, and so forth. And we do acknowledge that there is always going to be some distinction or separateness between that individual and another. In fact, uh, if there isn't that separateness, that's also pathological, right? We talk about enmeshment in families. All right, so, um, one way to deal with being isolated or being alone is denial. So people say, "No, everything's fine," or push things out of the surface. Now, uh, an existential crisis is, uh, normal, right? So, um, if a person, you know, has lived within

a framework for so long and then they step out of that framework, they might say, "Well, what is my purpose in life? What is...you know, what is my meaning?" What is the meaning of... My life, right? What am I here to do? Well, not knowing the answer to that question can result in anxiety; it can result in distress, and that's a common finding in research: not knowing one's purpose in life can result in increased anxiety. When I teach personality theory and I get to existential thought and humanistic thought, I usually ask my students, "Well, what

is your purpose in life, and what are you here to do in this world?" I have to tell you, this is an incredibly difficult question for college students to answer. Of course, most of the time I smile and then I say, "Well, if you can't answer that question, you're in good company," because most people at your phase of life are still trying to figure it out. There are some people who know from early childhood or middle childhood exactly what they're going to do, but for most people, it's not the case. Adolescence and emerging adulthood are

times of self-exploration, and that's what helps people figure out their purpose. Now, existentialists would say the answer to the question, "What is the meaning of my life?" well, the existentialists would say that life has no inherent meaning; it's up to you to define, create, or discover your meaning. There's no objective answer to this question. Your major challenge is to develop a sense of purpose and meaning in a world that appears meaningless, right? So, it's subjective to who you are. From this point of view, you become the meaning maker; you create the purpose for your life

in this world. And, you know, one thing that isn't said is that it can shift over time. What you think is your purpose and what you value may change across the lifespan. Having meaning, having purpose, having a connection to religion and spirituality tend to be fairly useful, and they tend to be adaptive in nature and promote healthy mental health. I may have said in another series that religion and spirituality were part of the discipline in its early stages; people like William James and others contributed to that. But it became taboo to talk about it when

we had Sigmund Freud, B.F. Skinner, and John Watson; they got rid of all of this. Religion and spirituality only began to re-emerge as a focus in the 1960s, but the research is strong that they promote positive mental health. Now, Viktor Frankl suggests that humans are always being pulled towards meaning. There is always a drive pulling us to reach our potential and do things that have purpose and meaning. Even though we're being pulled in that direction, the question is: Is there meaning in life towards which humans strive? Viktor Frankl says, "Yeah, humans have a will to

meaning." We have a basic tendency or drive to seek meaning, and in fact, meaning does exist in the world, but we don't attribute meaning to things; rather, we find it. We find meaning; we don't invent meaning; rather, we detect it. It's our job to identify and detect things that provide meaning to us. Another story—it's interesting to note that I'm a clinical psychologist and a professor. When I first started going to school, I knew that I wanted to be a clinical psychologist, but I did not know that I wanted to be a professor. Well, how did

I become a professor? It happened that my second semester of graduate school, I had a mentor who said, "Hey, do you want to make some money while going to graduate school?" I said, "Sure! I'm a broke college student, why not?" He said, "Well, we have what's called a graduate assistantship with CUNY, and that is to say we can give you a part-time teaching job." So I said, "Yeah, why not?" At that time, it paid $54 an hour, and I was like, "Holy smokes! You know, it beats the $10 an hour working in the pizza shop!"

So I agreed. I remember that when I went, they gave me "Introduction to Psychology," which is a survey course. It's one of the easier courses to teach because it's very broad but not deep. As you're in grad school, you're going to learn more and more, so I took it. I went to the secretary, and she gave me a book, "Exploring Psychology" by David Myers, and she said, "Good luck." There was a lot of anxiety, but when I stepped into the classroom for the first time, I fell in love with teaching. My whole mindset shifted from

wanting to be a clinical psychologist full-time to wanting to be a professor full-time and a part-time clinical psychologist. I never could have envisioned my path being what it was, but listening to my messages and listening to what made me feel like I was making a difference and shaping and guiding the next generation pulled me towards being a professor even more. Now I do both, but it's interesting that Viktor Frankl's words are so powerful to me. Either way, I would have meaning: I'm going to help people work through psychological distress, or I'm going to shape the

next generation. I could have never imagined that my life would be what it is today, and I'm grateful that I was willing to take the risk and change my path. So, we talked about logotherapy, right? Viktor Frankl. Talks about logotherapy, which is all about finding meaning, developing a sense of purpose, and celebrating our responsibility for free choice. Now, is Frankl the only one who talked about it? No, Irvin Yalom did too. Paths that provide meaning in an individual's life could be altruism—trying to do kind deeds not for the sake of a reward, but because it's

right and we want to better the world—dedication to a cause (right, that could be your calling), creativity, transcendence, or self-transcendence, and suffering. Now, suffering seems like an interesting one to be on the list, but people emerge from suffering. There's a great deal of research on something called post-traumatic growth; people can use their suffering as something that helps them define themselves and grow from it: religion, spirituality, hedonism—well, hedonism is if it's misused, but seeking purely pleasure—and then obviously self-actualization or reaching one's potential. So the goal of therapy is to increase self-awareness, to develop awareness related to

death, freedom, isolation, and life's meaning. We try to develop a sense of awareness, to develop that meaning, because eventually we are going to die and we're going to grapple with how we use our free will—whether we develop the sense of meaning or whether we feel isolated. Now, Bujintel talks about psychotherapy and self-discovery as follows: there is no final or definitive statement to be made about psychotherapy, about human psychology, about life. We are always in a process of sketching possibilities, of discovering, of becoming. And it's interesting; I love this quote because once we achieve the unimaginable,

life continues to occur. And now, after we've achieved things that we could have never imagined and we are still alive, well, then we create new goals and new ways to find purpose and meaning beyond that which we originally sketched out. So psychopathology, or psychological disorder, occurs from diminished self-awareness. Once again, Mujintel says that without awareness, we carry out pre-programmed actions, feel preset emotions, or act on predetermined judgments because we've lost our centers. So we go on autopilot, right? Going on autopilot and not being attuned and focused on purpose in life, we can develop emotional numbness;

we could have guilt and anxiety and avoid trying to feel those, and not reach our potential or not strive towards that which is our purpose in life. And all of that is according to Buchentel's existential psychopathology. So in terms of practitioners, what strategies do we use? What interventions do we use? Well, I will tell you that there is no singular handbook; this is existential therapy. It's actually pretty pragmatic, and it seems like a hodgepodge of techniques because the goal is to connect with the individual and help them grow. That is the goal, and if you're

going to follow technical interventions to a tee, you run the risk of losing genuineness. You can run the risk of appearing like a fake, a phony, or an artificial person. So trying to get people to focus on the "I-Thou" or the interpersonal experience is much better than rigidity with techniques. But of course, you know, we still have to talk about the things that are elements of therapy. One element is forming an "I-Thou" relationship. It helps people develop connection. Remember, we talked about people feeling disconnected or self-isolated? It helps develop a sense of immediacy, which is

linked to freedom, responsibility, and decision-making. It helps people develop self-awareness, insight, or depth. Because it's "I-Thou," it helps to develop mutuality versus an "I-It," where you're like that person and not you. "I-Thou" is you and me; we're connected and responsible for our outcomes. So that's the interpersonal element. And then, obviously, as therapists, we focus on transparency and authenticity. We are allowed to bring more of ourselves into the room. There is nothing wrong with sharing more about who you are and your experience, just being yourself. There's nothing wrong with that; you don't have to play a

role that has been scripted for you as a therapist. So we could talk about our experiences in the treatment; we could talk about our emotions in treatment, and so forth. So we highlight personal responsibility; you are the choices you make. If your choices are therapeutic, you're going to get better. If your choices are non-therapeutic, you're going to stay stuck. I use this as well in therapy when I talk to people, and I say, “Believe it or not, I am not the number one determinant of your success in therapy; you are." Because all I can give

you are tools, insight, and new ways of thinking about things that you might not have had, but ultimately you have to do the hard work. So if your choices lead you towards addressing whatever problems you have, then you're going to be better off for it. But if you engage in denial, resistance, avoidance, or withholding things that could be important, you're going to be as sick as your secrets. All right, now there is a presence that we use. We tend to be in the room as much as possible. I'm sure you've seen sometimes therapists can appear

distracted. The more interested we appear, the more fully in the room we are, the more presence we have, and the more impact we have. Right? So we also can do empathic mirroring and focusing. Mirroring and focusing can occur in three different ways, according to Kirk Schneider. You have a topical focus, which is "Take a moment to see what's present for you." That's really cool, right? Because most of us in therapy... We say, "Okay, what's going on? How has your week been?" These kind of things, and people can default to whatever they've been talking about. But

if we say, "Take a moment to see what's present for you," that could be anything that's happening in real time in this moment—right? A topical expansion. If someone is being superficial, you might say, "Tell me more about that." Or if they're trying to, uh, avoid the topic, you might say, "Hang on, hang on, stay with that for a minute," or "Sit with that for a minute," right? To help them further process the experience. And then, obviously, when there are discrepancies between what you're saying—something which is their content—and what you see them or experience them as,

their process, you can challenge them with that. You could say, "You know, you say you're fine, but your face is downcast." You know, sometimes people's words and their feelings can be incongruent, and our job is to highlight that. We offer feedback, right? So we provide information about what we're experiencing in the session. We provide confrontation. Now, confrontation is a tricky one because when you do confrontation, it has to come from a [Music] caring place. It has to come from a true intent of wanting to see a person grow, and it has to be done in

a compassionate way. So it doesn't mean that just because we're supportive, that we always agree with you. It is our job to challenge you with inconsistencies and discrepancies and things like that. It's our job, but we have to do it with your growth in mind, with your feelings in mind, in a way that is going to make you more likely to work on something rather than shut down. Now, mindfulness—which you might hear of as mindfulness-based cognitive therapy, mindfulness-based stress reduction techniques, and mindfulness therapies for dialectical behavioral therapy and things like that—at the heart of mindfulness

is being in the present without an agenda and accepting things for what they are. Well, if that is what mindfulness is, then mindfulness could also fit into an existential model. And then, of course, cognitive reframing, or reframing meaning, helps a person, you know, look at their experience from a negative way. So trying to make meaning out of suffering is a technique that Viktor Frankl used, but people like Albert Ellis and Aaron Beck—who are responsible for rational emotive behavioral therapy and traditional cognitive therapy—they used it too. So what's really cool is you're starting to see the

utility of existential therapy as it relates to other approaches. So the therapy skills—now, Adam said techniques are skills. Skills are owned. A hammer is only useful if you have the skill to use it, right? So, um, the techniques we use, I think that's what he's trying to say, is that the approaches we use in therapy—we may not use all of them, but the techniques we use, we have to be masterful with. So if, you know, we try and employ some strategy that we're not trained in, well then that's like using a hammer and not knowing

how to use it, right? It's going to be more destructive than constructive. All right, we also talk about paradoxical intention. Now, you heard about this from Alfred Adler in the previous presentation, but, um, with paradoxical intention, or the anti-suggestion, we encourage a person to intentionally exaggerate whatever the maladaptive experience is—or whatever the uncomfortable reality is—that's causing them anxiety. Now, the truth is, because things are paradoxical, you're going to automatically shift from that extreme point of view to the opposite extreme in a dialectical sense, right? So, um, even though it seems counterintuitive, by prescribing the problem,

um, then you actually help get growth. So it's pretty, uh, ingenious. Now, um, it naturally shifts your focus. You can also help a client distance themselves from whatever uncomfortability is by using humor. Humor is a powerful tool in therapy, and so forth. Now we talk about awareness and integration. Mahoney said all individuals experience natural human rhythms of expansion and constriction. So what is constriction? That's retreating or distancing oneself from contact with the outside world or whatever their problem is. Expansion—it's more like approaching the world, moving assertively in the world, and dealing with the pain, uh,

and risks that you take, and then ultimately growing from them. Now, so existential integrative psychotherapy takes our client awareness and our understanding of the natural problems and helps you find your center—help you find, you know, what grounds you. Now, what I'm going to do here is I'm going to show you a video, as I always do, and this video is going to be all about existential psychotherapy, um, and various elements of it. So let me share that screen, and I'm going to minimize myself, and we're going to start. [Music] This session is an example of

the existential approach, and it features a colleague of ours, Dr. Nilda Soto Bishop. If I were to try to boil down the existential perspective into a sentence or so, I’d say it focuses on meaning; and so the listening focus for the counselor or psychotherapist is on listening for what's important or meaningful to the individual client, right? I also think it's about self-awareness and consciousness, and it's about living life fully—embracing life fully—even in the face of death and other ultimate existential concerns, including aging, which is a big one for some of us. Peggy, who's featured in

this clip, is a 62-year-old graduate student, so obviously some of these issues are real for her, and Nilda helps Peggy focus on some doubts and some concerns, as well as being genuine. And spontaneous in the session, another thing is that she also tries to develop an I-vow relationship. I think that's consistent with existential theory. I have our relationship being of deep respect and honoring of the other person, and yet at the same time, being genuine and spontaneous. So let's watch Nelda and Peggy at work. [Music] Where do you want to go with this session? What

do you feel like you could benefit most from talking about this session? Well, you know that picture of the big jar and, uh, Stephen Covey, I think, and you put the jar filled with the big rocks, and then you say, "Is the jar full?" and you say, "Oh yes, the jar is full." And then he says, "Well, no, wait, look, you can put all this gravel in it." Yes, and then does it fall? Oh yeah, well, no, you can put the sand in and then put the water in. And then, what's the lesson? The people

always think the lesson is, "You can always get more in the jar," but the lesson is really that those big rocks have to go in first. So I've been thinking about that a lot. You have to know what the big rocks are and make sure they're in the jar. And so my family and work and school and my spiritual life are all in the jar. And I guess I would say that in these last few weeks, I just feel like those four rocks are jockeying for position in that jar. Yeah, okay, they're jockeying for position

in that jar, but they all fit in the jar. They're in the jar, and they fit. Yeah, so tell me, what position do they need to be in? Well, what are they? I actually would like to throw the work rock out of the jar. Oh really? Yeah, I feel frustrated at work; like it's just I'm in the wrong place, and it's taking up too much time for the amount of reward. All of the reward is just financial, and I am ready to say, you know, they always say, "Follow your passion." It's funny, and that seems

completely unrealistic, especially toward the end of life when you're supposed to be thinking of putting stuff away. But when I think I should just do this for another 10 years and retire, it just makes me feel like screaming and tearing out my hair. I physically can't do it; I have to do something else, something different. Yeah, it takes such a big chunk of life, you know? I’d like to say—in fact, I do say to my husband, "Why don't you just think about this and see how you feel?" And I actually do think that will be

part of the process when he just says, "You know, I just feel like you need to do this." And he hasn't said that yet. I mean, he's asked me if I think this is just an expensive hobby switch. Yeah, for a while, I could sort of agree with him. I sort of feel like I'm just doing it for fun, but the more I'm in the program, the more I sort of like fish or cut bait. You're either going to be invested in it, or else you're just, you know—like, I don't know, you just wanted a

diploma on your wall? That would be an expensive hobby. It would be an expensive hobby, but school was one of the rocks, yeah, and sounds like it incorporates some of that spiritual part and, yeah, and the work and family, right? It's bringing me together with my son, and my husband always just says, "I know you were born to go to school," so even if it's an expensive hobby, he wants to be able to provide that for me. Yes, and I think "born to go to school" is one thing, but "born to be in the program

you're in," yeah, that's different, isn't it? It's taken a while. Isn't that different? I can't—well, it's so many years when I didn't feel like a grown-up. I remember being at my daughter's volleyball game when she was in junior high, and during a break, the coach came over and was talking to some of us sitting on the bleachers. And in the middle of this conversation, which is always kind of difficult for me, I never can think of what to say, and I thought, "He thinks I'm a grown-up." I was like, I was a mom of a

teenage kid, but inside, no, that just wasn't going to go. Okay, that's the question: you know, tell me what being grown-up means to you. Well, just that sense, I guess, that you could make decisions about your own life, that you weren't just waiting for people to tell you what came next, and then you would go, "Okay." Although, I mean, even as I say that, I know with the kids that I just really like "give me those kids," and that was kind of primal and just in my bones. But in every other area, it was really

like that sense of not being able to ask for things. That was always pretty strong. In fact, it just seems like recently, since I've been coming to counseling, that I've had that feeling like, "Boy, I could ask for things that I want." And I think even in kind of little practical ways, like to say, "You know, I know you feel uneasy around my kids, but you think you could just come stay with them for an afternoon?" Even something like that, or "Yeah, I don't want to do that." And so something that I really want, like

this, I really, really want to go to school. And I am actually... Saying to my husband, "I really want to do this," and he and my son too. They go, "Are you sure? Do you really see yourself doing this?" Because it would sort of be pushing out into where I haven't really been before. I've done some training with parents, had groups for fostering and adoptive parents, but to act—to be a professional person now—that's sometimes you have to stop thinking that you would just be play-acting and think it's like applying to the program. We think, "They'll

never take me; that's ridiculous," and then going, "Well, why wouldn't they?" And the next thing is to say, "You'll never make it in the professional world," and to start saying, "Well, why not? Why wouldn't I?" That questioner—there's always a questioner there. And it's not just a questioner and kind of a doubter; there's always a doubter there, okay? Or is it to prove something? Okay, or the not grown-up here? I think it's the, um, the baby me that says too scary, too hard; the gifted child me that learned pretty quick—well, maybe not quick enough, but certainly

by sixth grade—that if you stand out, if you excel, if you put your head up where people can see you, somebody is going to chop that off. They're going to send you to the principal's office every day during art so that you can learn to type, or they're going to push you out of this grade into the next grade. You leave all your friends behind and meet a lot of people who think you have no business being there, or you know, whatever that thing is: don't stick out. And so it just makes you kind of

want to not rock the boat. I’m just wondering; this makes me curious about whether there’s part of that, um, gifted sixth grader you that knows that if you keep being gifted and you keep being outstanding, eventually someone's going to ask something of you you cannot accomplish, and then you're busted. No, I don't think it's like that at all, because it's thinking, "I can do something" that keeps me moving. It's like now when you just go, "Hey, okay, I've achieved anonymity. There's nobody around me; my kids are gone so they're not drawing in adverse attention," and

I just have a, you know, it's not a great job, but I just, you know, I have a job and I have good benefits, and I could just disappear in that thing. I could, but there's this thing inside that goes, "You who want more; you want more; you want more." And I think that's what struggles with that long-ago voice that says, and you know, if you reach for more, there's going to be penalties. And really, by seventh grade, they're going, "You have such great potential because you're scoring 99 all the way across on the achievement

test; then why aren't you doing better in school?" And by then, inside, you really are saying, "Are you kidding? I know better than that; no way am I going to just kind of stay down in the middle of the pack." But when life just gets routine and ordinary, boy, this thing comes out and goes, "You could have more than this." Nilda tries an explanation that Peggy says no to in this session, which I really like. I liked how that worked; I could feel Peggy's strengths in the relationship, and Nilda rolled with it. It was, "Yeah,

that's fine." You know, I think that flows from the existential concept of presence and sort of being present in the room, and Nilda is able to be accepting of Peggy having a different perspective than her, which is a really valuable thing. I also really like the moments in the session where Peggy says, "You want more; you want more," because I think it was exciting and fun, but also it's a preview of what's coming next. So let's watch for Nilda and Peggy working on some of those existential issues of delight and excitement. Listening to talk about

school, I understand that when you were with those kids raising kids, that was feeding you, and now you've moved into a different place, because at a certain point those kids are now going to be doing something different. They're on their own path, yeah? So here you are, and school is the next leg of your journey. It seems like that is the leg of the journey you're on, and when I hear you, when I see you, I just sense in you, as you talk about what school means to you, I sense that you are so delighted

and so comfortable, and you really have a sense inside you that this is the right thing for you right now. Yeah, I'm like psyched! I am psyched! Well, although, you know, that thing in me says, "You really think you can do this? I'm not sure if I can," but you know, semester by semester by semester, I am having a blast! I just like, you know, like people go, "What? You're taking nine credits this summer?" I go, "Yes!" Oh yeah, dog—can't wait! Yeah, so here's what I, out of curiosity, would like you to try—just sitting with

that delight and excitement that you feel. There’s both; there’s a delight and an excitement. And just sit with that for a little while and see what you get from that. And maybe if you could, if you would like to, scan your body from head to foot and from, you know, down your—don't forget your shoulders and arms—and tell me, where do you hold that in your body? Where do you hold that? Absolutely. Absolutely right here. Better cheesecake, better than Jesus. Oh yeah, it's just right. There, what does it feel like? There, it just feels full. Like

full and satisfying. Like instead of, like, what? What do I need? What do I need? What do I need? Let's go! Hot diggity! Awesome! Yeah, that's good. That's lovely. You don't feel that when you talk about work, but work is the purpose of work is to support. Perhaps, well, it helps me go to school, and that gives it some meaning, and that gives you the meaning. So, I'm getting other people into school. That's something! So, I'm involved with a lot of people. That part is good. It's not like just total bust, but it's a frustrating

setup, and it's not very energizing. It could be, but the parts that could be seem like they're always getting chopped off at the knees. So, when we talk about your experience in school being about delight and excitement, see if you can give me some words for your experience at work. Well, you talked about me taking care of people. That's certainly one thing. It just seems like my co-workers are all kind of falling apart at the seams for various reasons, and it's very important that I just be the person that shows up every day, that's reliable,

and that is not having crises. Although, you know, I have to run off for this kid or that kid, but not very often anymore. And when I first went, I was crying all the time, with what we've been through with my youngest boy. But now, that hardly ever happens. I'm usually just pretty together. I resent it sometimes because sometimes I just need to not be the person that's holding everything together. But, if school is excitement and delight, work is, uh... it's hygiene, I guess. I don't know what's like hygiene. Yeah, it's like shaving your legs

or something. You have to do it, but... yeah, actually, that's not a good example. Just something like that, you know? It's just one of those things. Who likes flossing their teeth? But you just do it, and that's sort of like that. So, it's not like a complete waste of time. It's got an important function, but it's just not very fun. I don't look forward to it, and I don't... I just, I think I put on Facebook, somebody said, "When I die, I'm going to be sorry I didn't spend more time just flossing my teeth." Right?

It's that kind of thing. So, it's not a waste of time. No, it's not a waste, and it's something worthwhile. I, you know, I feel good about what I'm doing. I have good connections with other clerical staff that need me to give them support and to help do some training for them and be there and answer questions, and getting people into school is good. I have really, you know, enjoyable contacts with students. So, it's not like the job from hell. Does that gifted little girl come into that job at all? Okay, so she would... they

could let me write a lot more web pages and let me have my own login so I don't have to do everything, give it to somebody else and hope it turns up sometime in the next three months, and revise the letters so that they really know. And they always sort of say, "Yes, you can do this," but in reality, it turns out that you can't. So, that's frustrating. I mean, there are times when I think this could be a pretty interesting job, and you could go out and do some training and develop some materials. But

the university is... I'm giving "creative" is not one of the adjectives you would use to describe this job. And you kind of... I like to... my feeling is that you really need for things to be very creative in your life. Solutions, you know? My dad was an engineer, and sometimes I thought if I had known it was going to take me twenty years to get married, I would go back and do that part and be an engineer of some kind, either industrial or a civil engineer, and design things and build things. But I thought at

the time I wasn't very good at math, and I thought, "I'm going to have kids." That was like my goal, and I got that goal. And, you know, I was telling you before that sometimes I thought, "Boy, doing that just chopped a hole in the middle of my life, and now I'll never get to do these things I'm really starting to love, because I took twenty years of my life and was out of the workforce." But I'm not sorry I did that. That was what I wanted to do, and I did it. It pushed me

harder. Your choice! You made that very deliberate choice. If I had birthed those kids, that would have been, you know, a different picture. A whole different picture. But as it was, they needed me. I needed them. It was a good symbiotic relationship, and I think it's put me on the path to where I am now. I think it's brought things out of me that I didn't know I had. So, when I didn't feel like I'd grown up, when I felt like I had to hide from every scary thing, I could not hide from their scary

things because they were my kids. So, that was a different way of approaching life than I had had before. It was like, you can disappear, disappear. You know, I led me to pile on all this weight, because that makes you invisible in this culture. But with my kids, I couldn't afford... To disappear because they needed to have somebody advocate for them, and so they pulled me back to life in a way. I mean, I always thought, "I just want a boring, simple life." I would think that, but it wasn't true, and they're the ones that

really, you know, just called my bluff. I didn't want life to be boring and simple, and challenging kind of struck as you talk about that. The word that kind of stayed with me in all of that, I mean, concepts stay with me, but the word that stayed with me through that is "symbiotic," because it seems a really important part of your life. It seems, when I look at these rocks, pretty much it's all—everything you do is kind of symbiotic; everything is supporting everything in your life. It's kind of the integrative force, so they all just

pull together. Sort of—that's the worst same kind of the work doesn't want to. Rita, in that preceding segment, I really liked the part where they're using the metaphor, and Peggy talks about really feeding herself—feeding herself with school, with something that gives her delight, and it's obviously very positive in her life. Yeah, and of course, as professors, how could we not love that? She pats her stomach and says, "It feels as good as cheesecake; it even tastes better than cheesecake." I think this is consistent with what Kirk Schneider, who's a famous existential writer, talks about when

he says embracing the awe of life—kind of rediscovering the awe or the excitement, the deep excitement of life. Yeah, obviously for Peggy, and her stage of life and her issues, existential work is a great avenue for her. All right, so yeah, I actually like that video on many fronts because it highlights how one's purpose in life can shift across the lifespan. It highlights how different aspects of who we are can inform other aspects of who we are. It highlights the responsibility factor—Peggy did not like to go to work, but she recognized that as one of

her responsibilities in life, and it serves a function, a productive function. But it's like flossing or shaving—things like that that you know are necessary but not as enjoyable. I also thought that Peggy was very insightful; like, you could see that she spent a lot of time thinking about who she is and, you know, her various roles in life. And then, you know, one thing that if I were in the room, I might have probed is sort of like, you know, taking the metaphor, making it more tangible—not overly intellectualizing her experience. But overall, I mean, the

therapy session was a good one. I think that the clinician did a fantastic job getting Peggy to talk and reflect on her experience. So let's go back into the PowerPoint and talk about how we do treatment planning and assessment. If we are going to determine what, you know, one's character and try to help them understand who they are, we can do many instruments. There's a Life Regard Index, there's a Purpose in Life test—I use that a lot, actually. There's the Noetic Goals test, spiritual meaning scale, mindfulness, and a bunch of these that we could use

to help a person better gain clarity of who they are. So, when we talk about this, let's evaluate it. So, you know, it's really cool that it's very theoretical in nature and very pragmatic in nature. But here are some views of existential therapy: how can a renewed sense of humility and wonder, indeed amazement before the whole life, be measured? Right? So, I think Kirk Schneider is saying here, you know, it's hard to pin the theory down a bit because it's so broad and overarching. Rollo May talks about the essential movement in psychiatry arising out of

a passion to be not less but more empirical. So there is empirical research on this. We see that existential group therapy works; we see that existential integrative therapy works. And Wampold, which is a famous research on the various therapeutic models, describes existential integrative therapy as scientific. Now, in terms of the multicultural and feminist point of view, there is a critique that it still remains too narrowly focused on the purpose in life, but doesn't really emphasize how that meaning-making shifts across various identities such as cultural identity, gender-based identity, financial status, and so forth. So, just to

highlight this, Prochaska and Norcross, who wrote a book on counseling, talked about how only in existentialism and in the movies do people possess unlimited freedom, construct their own meanings, and execute boundless choices—save it for the wealthy, worried well. So, highlighting that, perhaps it really is out of touch with the experiences of lower-income communities and whatnot, whereas other people think that, you know, because this model is very respectful in nature and gentle in nature, it can be diversity-sensitive. Now, gender and sexuality—an early affirmation of sexual identity is viewed as making counseling and psychotherapy more accessible. Right?

So, declaring one's either self-identity or ally status could be useful; encouraging questioning and forming meaning and identity can also be useful, and so forth. Now, in terms of spirituality and writings, Schneider talks about the rediscovery of awe. Franklin Wong talked about the pursuit of meaning and so forth. So, a long story short is if we were to critique it, it is empirical; the science is there. It has, in its writing, not enough about gender and multicultural differences, but can be applied. Um, and then one nice thing is it uses religion and spirituality to its benefit.

Right, so let's conclude with some final thoughts. Existential therapy is all about finding meaning. It's about recognizing that we die, and oftentimes, uh, we're very much alone, but at the same time, we're responsible for our choices. So, with that, I'm going to stop, and we'll continue with the next, uh, lecture in the series. All right, well, take care, everybody. See you next time.